A right to health care? It’s headed to Oregon ballots in 2022

By Dirk VanderHart (OPB)
May 19, 2021 5:49 p.m.

After at least eight proposals over 16 years, the so-called “Hope Amendment” passed the Oregon Legislature on Wednesday.

A stack of envelopes is printed with the words "Ballot enclosed" on each.

The Hope Amendment would ask Oregon voters to change the state constitution to make health care a fundamental right. If approved by the state House on Wednesday, it will be on ballots in November 2022.

Kristyna Wentz-Graff / OPB

Oregon voters will decide next year whether the state constitution should guarantee “cost-effective, clinically appropriate and affordable health care” as a fundamental right.


On Wednesday, the state House of Representatives passed Senate Joint Resolution 12, the so-called “Hope Amendment.” It’s a familiar idea in Salem — the resolution marks at least the eighth time in 16 years a proposal to make health care a constitutional right has been introduced in Oregon.

With Wednesday’s vote, the matter will go before voters in November 2022.

It’s fitting that the amendment’s ultimate passage took place in the House. The proposal had been a fervent goal of longtime state Rep. Mitch Greenlick. The Portland Democrat died a year ago, after floating the idea for his final time in the 2020 legislative session. Greenlick’s proposal likely would have passed then if a Republican walkout over climate change legislation hadn’t brought the session to a premature end.

Rep. Mitch Greenlick, D-Portland, sits at a desk on the House floor at the Capitol in Salem, Oregon.

Former state Rep. Mitch Greenlick, D-Portland, was a fervent supporter of making healthcare a constitutional right. Greenlick died a year ago.

Kaylee Domzalski / OPB

“He believed very passionately in this idea, as I do,” state Rep. Rob Nosse, a Portland Democrat and chief co-sponsor of SJR 12, said in a committee hearing earlier this month.

The measure that voters will be asked to decide on is brief, but its likely effects are hotly contested within the Capitol.

While it would amend the state’s constitution to establish health care as a right for all citizens, the amendment also contains something of a loophole: It says that obligation “must be balanced against the public interest in funding public schools and other essential public services.” The amendment adds that any attempt to sue the state to demand universal health care coverage “may not interfere” with that balance.

“This is setting the groundwork for the Legislature to take action,” state Sen. Michael Dembrow, D-Portland, said when the Senate approved the voter referral in March. “It’s not a specific proposal. It’s more a set of values and a call to action.”


But Republicans warn the amendment will be a weighty change. They believe that voters will pass the measure by a wide margin next year, and that Oregon could be on the hook for billions in new health care spending when they do.

“It’s going to either be an absolutely empty promise that we have no intention of keeping, or it’s going to be a right that’s going to bankrupt the state,” Senate Minority Leader Fred Girod, R-Lyons, said in March.

State Rep. Cedric Hayden, R-Roseburg, has gotten an opinion from legislative attorneys that he says shows the amendment would be more meaningful than Democrats say.

“This isn’t aspirational,” Hayden said Tuesday. “You have to take action.”

The opinion Hayden requested does suggest that lawmakers couldn’t simply sit on their hands if citizens pass the Hope Amendment.

“On its face, the text of SJR 12 does not require the state to implement any further policies if current state policies satisfactorily ensure access to cost-effective, clinically appropriate and affordable health care for every resident of Oregon,” Lorey Freeman, an attorney with the office of legislative counsel, wrote in the document. “However, if current policies do not satisfy the state’s obligation, the state—presumably the Legislative Assembly and the executive branch— would be required to take steps to fulfill the right of each resident of Oregon to access health care.”

According to the Oregon Health Authority, 94% of Oregonians had health insurance coverage in 2019. Lawmakers and others have been meeting in a task force on universal health care in order to consider ways to serve the other 6%.

In a May 6 appearance before the House Health Care Committee, Freeman added that the amendment, if passed, could create the right for someone to sue in order to force the state to fulfill its obligation to provide health care. But she also opined that the provision allowing lawmakers to balance that right against other services would likely protect the state.

“A court would be very unlikely to second guess the Legislature’s choices on how to allocate its resources,” Freeman said.

The Hope Amendment received backing this session from a range of interests, including health-care providers, organized labor, and good governance groups. One of them, the League of Women Voters of Oregon, didn’t supported a version of the proposal introduced as recently as 2018, but with the addition of a provision that could ensure the state is not forced to expand health care it came on board.

“The HOPE Amendment is simply an aspirational bill that asks two basic questions: Is health care a right or is it a privilege? Is Oregon committed to ensuring that every individual has access to some form of health insurance as it is afforded in every other modern country?” the organization wrote in testimony submitted this year.

But Republicans have largely panned the idea, arguing that the risks are far greater than supporters suggest. The bill passed the Senate on a near-party-line vote, with Democratic Sen. Betsy Johnson joining Republicans in opposition.